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Pediatrics. 2002 Jun;109(6):1068-73.

Second varicella infections: are they more common than previously thought?

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Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.



To describe the epidemiology and clinical characteristics of varicella reinfections reported to a surveillance project.


We investigated varicella cases reported to a surveillance project between January 1, 1995, and December 31, 1999--with more extensive investigation of cases reporting previous varicella with onset between January 1, 1998, and September 30, 1998--to provide a more detailed description of first and second varicella infections. A simple decision tree was used to assess the likelihood that reported first and second infections were varicella.


Among varicella cases reported to the surveillance project, 4.5% of cases in 1995 and 13.3% of cases in 1999 reported previous varicella. More than 95% of first infections were physician diagnosed, epidemiologically linked to another case, or had a rash description consistent with varicella; the same was true for reported second infections. People who reported reinfections were generally healthy. There was a family history of repeat infections in 45% of people who reported reinfections.


Clinical varicella reinfections may occur more commonly than previously thought. Additional studies of the predictive value of a positive varicella history and laboratory studies of reported reinfections are indicated to guide varicella vaccination policy.

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